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    Observations on significant hemodynamic changes caused by a high concentration of epidurally administered ropivacaine: correlation and prediction study of stroke volume variation and central venous pressure in thoracic epidural anesthesia.
    BMC Anesthesiol 2017 Nov 16;17(1):153. Epub 2017 Nov 16.
    Department of Anesthesia and Pain Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602739, South Korea.
    Background: Thoracic epidural anesthesia (TEA) exacerbates hypotension due to peripheral vasodilator effects following the use of general anesthetics. This study aimed to compare the hemodynamic changes caused by three different concentrations of epidural ropivacaine and to evaluate the performance of the stroke-volume variation (SVV) and central venous pressure (CVP) during TEA with general anesthesia.

    Methods: A total of 120 patients were administered 8 mL of ropivacaine solution via epidural injection, following randomization into one of three groups based on the concentration of ropivacaine in the study solution: 0. Read More

    Using Activity Trackers to Quantify Postpartum Ambulation: A Prospective Observational Study of Ambulation after Regional Anesthesia and Analgesia Interventions.
    Anesthesiology 2017 Nov 14. Epub 2017 Nov 14.
    From the Department of Obstetrics and Gynecology (J.M., M.P.G.) and the Department of Anesthesia (R.M., B.C., M.G., J.G.L., F.W.A.), University of Toronto, Toronto, Ontario, Canada; and the Department of Obstetrics and Gynecology (J.M., M.P.G.) and the Department of Anesthesia (R.M., B.C., M.G., J.G.L., F.W.A.), St. Michael's Hospital, Toronto, Ontario, Canada; the Department of Obstetrics and Gynecology, Dalla Lana School of Public Health (J.M.), Toronto, Ontario, Canada; the Department of Anesthesia, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada (J.G.L., F.W.A.); the Department of Anesthesia, School of Medicine, National University of Ireland, Galway, Ireland (J.G.L.); and the Department of Anesthesiology and Pain Medicine and the Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada (F.W.A.).
    Background: Early postoperative ambulation is associated with enhanced functional recovery, particularly in the postpartum population, but ambulation questionnaires are limited by recall bias. This observational study aims to objectively quantify ambulation after neuraxial anesthesia and analgesia for cesarean delivery and vaginal delivery, respectively, by using activity tracker technology. The hypothesis was that vaginal delivery is associated with greater ambulation during the first 24 h postdelivery, compared to cesarean delivery. Read More

    Chronic administration of parecoxib exerts anxiolytic-like and memory enhancing effects and modulates synaptophysin expression in mice.
    BMC Anesthesiol 2017 Nov 13;17(1):152. Epub 2017 Nov 13.
    Department of Physiology, College of Medicine, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
    Background: Previous studies have shown that cyclooxygenase-2, a key enzyme that converts arachidonic acid to prostaglandins, is involved in anxiety and cognitive processes, but few studies have investigated the effects of chronic administration of cyclooxygenase-2 inhibitors on anxiety, learning and memory under normal physiological conditions. The aim of the study was to investigate the effects of chronic administration of parecoxib, a cyclooxygenase-2 inhibitor, on anxiety behavior and memory performance under normal physiological conditions and to explore the possible neural mechanism underlying parecoxib-mediated effects.

    Methods: Adult male ICR mice were randomly divided into four groups: the control group and three parecoxib groups. Read More

    A Comparison of Red Cell Rejuvenation versus Mechanical Washing for the Prevention of Transfusion-Associated Organ Injury in Swine.
    Anesthesiology 2017 Nov 9. Epub 2017 Nov 9.
    From the Department of Cardiovascular Sciences and NIHR Biomedical Research Centre, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, United Kingdom (M.J.W., S.Q., N.S., W.D., M.N., T.K., A.H.G., G.J.M.); National Health Service Blood and Transplant, Cambridge CB2 0PT, United Kingdom (R.C., M.W.); and National Heart and Lung Institute, Imperial College London, London W12 0NN, United Kingdom (N.N.P.).
    Background: We evaluated the effects of two interventions that modify the red cell storage lesion on kidney and lung injury in experimental models of transfusion.

    Methods: White-landrace pigs (n = 32) were allocated to receive sham transfusion (crystalloid), 14-day stored allogeneic red cells, 14-day red cells washed using the red cells washing/salvage system (CATS; Fresenius, Germany), or 14-day red cells rejuvenated using the inosine solution (Rejuvesol solution; Zimmer Biomet, USA) and washed using the CATS device. Functional, biochemical, and histologic markers of organ injury were assessed for up to 24 h posttransfusion. Read More

    Targeted Genotyping Identifies Susceptibility Locus in Brain-derived Neurotrophic Factor Gene for Chronic Postsurgical Pain.
    Anesthesiology 2017 11 9. Epub 2017 Nov 9.
    From the Department of Anaesthesia and Intensive Care (Y.T., X.L., Z.M., S.K., I.H.T.H., B.J., S.T., T.G., W.K.K.W., M.T.V.C.), Li Ka Shing Institute of Health Sciences (Y.T., X.L., S.K., I.H.T.H., B.J., S.T., S.H.W., J.Y., W.K.K.W., M.T.V.C.), School of Biomedical Sciences (Y.S., C.H.K.C.), and Department of Medicine and Therapeutics (S.H.W., J.Y., W.K.K.W.), Institute of Digestive Disease, State Key Laboratory of Digestive Disease, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China; the Shandong Provincial Key Laboratory of Mental Disorders, Department of Neurobiology, School of Medicine, Shandong University, Jinan, Shandong, China (M.J., H.Y., Z.C.); the Institute of Human Genetics, Helmholtz Zentrum München, Neuherberg, Germany (P.L); and the Department of Anaesthesia and Intensive Care, Tuen Mun Hospital, Hong Kong Special Administrative Region, China (B.C.P.C., C.K.M.L.). Prince of Wales Hospital, Hong Kong Special Administrative Region. Prince of Wales Hospital, Hong Kong Special Administrative Region. Prince of Wales Hospital, Hong Kong Special Administrative Region. Prince of Wales Hospital, Hong Kong Special Administrative Region. Prince of Wales Hospital, Hong Kong Special Administrative Region. Prince of Wales Hospital, Hong Kong Special Administrative Region. Prince of Wales Hospital, Hong Kong Special Administrative Region. Prince of Wales Hospital, Hong Kong Special Administrative Region. Tuen Mun Hospital Tuen Mun Hospital The Chinese University of Hong Kong.
    Background: The purpose of this study was to evaluate the association between single-nucleotide polymorphisms and chronic postsurgical pain.

    Methods: Using GoldenGate genotyping assays, we genotyped 638 polymorphisms within 54 pain-related genes in 1,152 surgical patients who were enrolled in our Persistent Pain after Surgery Study. Patients were contacted by phone to determine whether they had chronic postsurgical pain at 12 months. Read More

    Mechanical strain to maxillary incisors during direct laryngoscopy.
    BMC Anesthesiol 2017 Nov 7;17(1):151. Epub 2017 Nov 7.
    Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA.
    Background: While most Direct laryngoscopy leads to dental injury in 25-39% of cases. Dental injury occurs when the forces and impacts applied to the teeth exceed the ability of the structures to dissipate energy and stress. The purpose of this study was to measure strain, (which is the change produced in the length of the tooth by a force applied to the tooth) strain rate, and strain-time integral to the maxillary incisors and determine if they varied by experience, type of blade, or use of an alcohol protective pad (APP). Read More

    Membrane protein Nav1.7 contributes to the persistent post-surgical pain regulated by p-p65 in dorsal root ganglion (DRG) of SMIR rats model.
    BMC Anesthesiol 2017 Nov 7;17(1):150. Epub 2017 Nov 7.
    Department of Anesthesiology, the First Affiliated Hospital, Zhengzhou University, No 1, Jianshe Road, Zhengzhou, 450052, People's Republic of China.
    Background: Persistent post-surgical pain is a difficult clinical problem. In this study, we intend to explore the mechanism underlying the persistent post-surgical pain in SMIR (skin/muscle incision and retraction) rats.

    Methods: First of all, the expression of membrane protein Nav1. Read More

    An Anesthesiologist's Perspective on the History of Basic Airway Management: The "Progressive" Era, 1904 to 1960.
    Anesthesiology 2017 Nov 7. Epub 2017 Nov 7.
    From the Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.
    This third installment of the history of basic airway management discusses the transitional-"progressive"-years of anesthesia from 1904 to 1960. During these 56 yr, airway management was provided primarily by basic techniques with or without the use of a face mask. Airway maneuvers were inherited from the artisanal era: head extension and mandibular advancement. Read More

    Effects of Changes in Arterial Carbon Dioxide and Oxygen Partial Pressures on Cerebral Oximeter Performance.
    Anesthesiology 2017 Oct 30. Epub 2017 Oct 30.
    From the Departments of Anesthesia and Perioperative Care (A.S., J.R.F, P.E.B., M.D.R.), Obstetrics and Gynecology, and Surgery (M.D.R.), University of California, San Francisco, California.
    Background: Cerebral oximetry (cerebral oxygen saturation; ScO2) is used to noninvasively monitor cerebral oxygenation. ScO2 readings are based on the fraction of reduced and oxidized hemoglobin as an indirect estimate of brain tissue oxygenation and assume a static ratio of arterial to venous intracranial blood. Conditions that alter cerebral blood flow, such as acute changes in PaCO2, may decrease accuracy. Read More

    Central Venous Catheters in Small Infants.
    Anesthesiology 2017 Oct 30. Epub 2017 Oct 30.
    From the Department of Anesthesia and Pain Management, Royal Children's Hospital, Melbourne, Australia (C.B.); Anaesthesia and Pain Management Research Group, Murdoch Children's Research Institute, Melbourne, Australia (C.B.); and the Department of Anesthesia, Intensive Care and Pain Management, Robert Debré University Hospital, Paris, France (S.M.).

    Effects of lung protective mechanical ventilation associated with permissive respiratory acidosis on regional extra-pulmonary blood flow in experimental ARDS.
    BMC Anesthesiol 2017 Oct 27;17(1):149. Epub 2017 Oct 27.
    Department of Anesthesia and Intensive Care Medicine, University Hospital of Bonn, Bonn, Germany.
    Background: Lung protective mechanical ventilation with limited peak inspiratory pressure has been shown to affect cardiac output in patients with ARDS. However, little is known about the impact of lung protective mechanical ventilation on regional perfusion, especially when associated with moderate permissive respiratory acidosis. We hypothesized that lung protective mechanical ventilation with limited peak inspiratory pressure and moderate respiratory acidosis results in an increased cardiac output but unequal distribution of blood flow to the different organs of pigs with oleic-acid induced ARDS. Read More

    Effects of Forced Air Warming on Airflow around the Operating Table.
    Anesthesiology 2017 Oct 26. Epub 2017 Oct 26.
    From the Operating Rooms, Kyushu University Hospital, Fukuoka, Japan (K.S., H.S.); the Department of Anesthesiology, Kyushu Medical Center, Fukuoka, Japan (T.K.); Central Uni Co., Ltd., Fukuoka, Japan (N.A.); and the Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.H.).
    Background: Forced air warming systems are used to maintain body temperature during surgery. Benefits of forced air warming have been established, but the possibility that it may disturb the operating room environment and contribute to surgical site contamination is debated. The direction and speed of forced air warming airflow and the influence of laminar airflow in the operating room have not been reported. Read More

    Propofol inhibits the release of interleukin-6, 8 and tumor necrosis factor-α correlating with high-mobility group box 1 expression in lipopolysaccharides-stimulated RAW 264.7 cells.
    BMC Anesthesiol 2017 Oct 26;17(1):148. Epub 2017 Oct 26.
    Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
    Background: Studies have found that propofol can inhibit endotoxin-induced monocyte-macrophages to produce various inflammatory factors. This study is to disclose whether the propofol affects the expression of high-mobility group box 1 (HMGB1) in lipopolysaccharides (LPS)-stimulated RAW 264.7 cells and the release of interleukin-6 (IL-6), 8 (IL-8) and tumor necrosis factor-α (TNF-α). Read More

    The obesity conundrum in sepsis.
    BMC Anesthesiol 2017 Oct 25;17(1):147. Epub 2017 Oct 25.
    Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, USA.
    While the long-term negative effects of obesity on health is a well-studied phenomenon, its effects on acute illnesses seem to be the contrary. Several studies have indicated the possibility of an 'obesity paradox' in sepsis - where overweight and obese patients have better outcomes than normal weight patients. These meta-analyses including large numbers of patients across different countries raised an interesting but debatable topic. Read More

    Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System: A Randomized, Double-blinded, Controlled Trial in Major Abdominal Surgery.
    Anesthesiology 2017 Oct 25. Epub 2017 Oct 25.
    From the Department of Anesthesiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium (A.J., B.I., K.T., L.B., L.V.O.); Department of Anesthesiology, Brugmann Hospital, Université Libre de Bruxelles, Brussels, Belgium (A.D., I.S., P.V.d.L.); Department of Abdominal Surgery, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium (P.L.); Department of Anesthesiology and Perioperative Medicine, University of California Irvine, Irvine, California (J.R.); and Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California (M.C.).
    Background: The type of fluid and volume regimen given intraoperatively both can impact patient outcome after major surgery. This two-arm, parallel, randomized controlled, double-blind, bi-center superiority study tested the hypothesis that when using closed-loop assisted goal-directed fluid therapy, balanced colloids are associated with fewer postoperative complications compared to balanced crystalloids in patients having major elective abdominal surgery.

    Methods: One hundred and sixty patients were enrolled in the protocol. Read More

    Propofol-induced Changes in α-β Sensorimotor Cortical Connectivity.
    Anesthesiology 2017 Oct 25. Epub 2017 Oct 25.
    From the Department of Neurosurgery (M.M., N.A., C.M.P., E.T., N.P.), Department of Bioengineering (N.P.), Neuroscience Interdepartmental Program (N.P.), Brain Research Institute (N.P.); and Department of Anesthesiology (A.E.H.), University of California, Los Angeles, California.
    Background: Anesthetics are believed to alter functional connectivity across brain regions. However, network-level analyses of anesthesia, particularly in humans, are sparse. The authors hypothesized that propofol-induced loss of consciousness results in functional disconnection of human sensorimotor cortices underlying the loss of volitional motor responses. Read More

    Assessment of Haemostasis in patients undergoing emergent neurosurgery by rotational Elastometry and standard coagulation tests: a prospective observational study.
    BMC Anesthesiol 2017 Oct 24;17(1):146. Epub 2017 Oct 24.
    Department of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva, -1211, Geneva, CH, Switzerland.
    Background: Rotational elastometry (ROTEM) has been shown useful to monitor coagulation in trauma patients and in major elective surgery. In this study, we aimed to evaluate the utility of ROTEM to identify hemostatic disturbances and to predict the need for transfusion, compared with standard coagulation tests (SCTs) in patients undergoing emergent neurosurgery.

    Methods: Over a four-year period, adult patients who met criteria for emergent neurosurgery lasting more than 90 min were included in the study. Read More

    No Differences in Renal Function between Balanced 6% Hydroxyethyl Starch (130/0.4) and 5% Albumin for Volume Replacement Therapy in Patients Undergoing Cystectomy: A Randomized Controlled Trial.
    Anesthesiology 2017 Oct 24. Epub 2017 Oct 24.
    From the Departments of Anesthesiology (T.K., F.B., S.H., N.H., F.K., J.P., K.H.-K., P.C., M.R.) and Urology (A.K.), Hospital of the University of Munich, and Department of Medical Informatics, Biometry, and Epidemiology (A.C.), Ludwig-Maximilians-Universität München, Munich, Germany.
    Background: The use of artificial colloids has declined in critical care, whereas they are still used in perioperative medicine. Little is known about the nephrotoxic potential in noncritically ill patients during routine surgery. The objective of this trial was to evaluate the influences of albumin 5% and balanced hydroxyethyl starch 6% (130/0. Read More

    Computer-controlled closed-loop drug infusion system for automated hemodynamic resuscitation in endotoxin-induced shock.
    BMC Anesthesiol 2017 Oct 23;17(1):145. Epub 2017 Oct 23.
    Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, 565-8565, Japan.
    Background: Hemodynamic resuscitation in septic shock requires aggressive fluid replacement and appropriate use of vasopressors to optimize arterial pressure (AP) and cardiac output (CO). Because responses to these drugs vary between patients and within patient over time, strict monitoring of patient condition and repetitive adjustment of drug dose are required. This task is time and labor consuming, and is associated with poor adherence to resuscitation guidelines. Read More

    Effect of interscalene block on intraocular pressure and ocular perfusion pressure.
    BMC Anesthesiol 2017 Oct 23;17(1):144. Epub 2017 Oct 23.
    Department of Orthopedics and Traumatology, Konya Training and Research Hospital, Konya, Turkey.
    Background: Interscalene block (ISB) is commonly associated with Horner's syndrome due to spread of local anesthetic to the cervical sympathetic chain. Postganglionic neurons that originate from superior cervical ganglia form the sympathetic innervation of eye. Decrease in sympathetic tone may change intraocular pressure (IOP) and ocular perfusion pressure (OPP). Read More

    Perioperative management of paraganglioma and catecholamine-induced cardiomyopathy in child- a case report and review of the literature.
    BMC Anesthesiol 2017 Oct 17;17(1):142. Epub 2017 Oct 17.
    Department of Anesthesiology, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China.
    Background: Paragangliomas are catecholamine-secreting tumors of the paraganglia. Perioperative mortality of children with paraganglioma is high, but preoperative therapy and anesthetic management of paraganglioma resection are controversial in children. The literatures on catecholamine-induced cardiomyopathy are limited to several case reports,with few reports of studies on children. Read More

    Intraoperative continuous cerebral microcirculation measurement in patients with aneurysmal subarachnoid hemorrhage: preliminary data on the early administration of magnesium sulfate.
    BMC Anesthesiol 2017 Oct 17;17(1):143. Epub 2017 Oct 17.
    Department of Anesthesiology, University Hospital Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany.
    Background: In patients with subarachnoid hemorrhage (SAH), vasospasm remains one of the major complications. The application of intravenous magnesium sulfate (MgSO4) has been under discussion to prevent cerebral ischemia. Our aim was to examine the impact of early MgSO4 administration on local cerebral microcirculation during microsurgical clipping of SAH-related aneurysms. Read More

    Preparing for the unexpected: special considerations and complications after sugammadex administration.
    BMC Anesthesiol 2017 Oct 17;17(1):140. Epub 2017 Oct 17.
    Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, Florida, 32224, USA.
    Sugammadex, a modified gamma-cyclodextrin, has changed clinical practice of neuromuscular reversal dramatically. With the introduction of this selective relaxant binding agent, rapid and reliable neuromuscular reversal from any depth of block became possible. Sugammadex can reverse neuromuscular blockade without the muscarinic side effects typically associated with the administration of acetylcholinesterase inhibitors. Read More

    Role of tube size and intranasal compression of the nasotracheal tube in respiratory pressure loss during nasotracheal intubation: a laboratory study.
    BMC Anesthesiol 2017 Oct 17;17(1):141. Epub 2017 Oct 17.
    Department of Anesthesiology, Nara Hospital, Kindai University Faculty of Medicine, 1248-1 Otodacho, Ikoma, Nara, 630-0293, Japan.
    Background: Small nasotracheal tubes (NTTs) and intranasal compression of the NTT in the nasal cavity may contribute to increasing airway resistance. Since the effects of size, shape, and partial compression of the NTT on airway resistance have not been investigated, values of airway resistance with partial compression of preformed NTTs of various sizes were determined.

    Methods: To determine the factors affecting the respiratory pressure loss during the nasotracheal intubation, physical and fluid dynamics simulations were used. Read More

    Failure of Isoflurane Cardiac Preconditioning in Obese Type 2 Diabetic Mice Involves Aberrant Regulation of MicroRNA-21, Endothelial Nitric-oxide Synthase, and Mitochondrial Complex I.
    Anesthesiology 2017 Oct 17. Epub 2017 Oct 17.
    From the Departments of Anesthesiology (Z.-D.G., S.Q., X.B., D.C.W., J.R.K., Z.J.B.) and Physiology (Y.L., Z.J.B., M.L.), Medical College of Wisconsin, Milwaukee, Wisconsin. Current affiliation: Department of Ophthalmology, Stanford University School of Medicine, Stanford, California (Z.-D.G.).
    Background: Diabetes impairs the cardioprotective effect of volatile anesthetics, yet the mechanisms are still murky. We examined the regulatory effect of isoflurane on microRNA-21, endothelial nitric-oxide synthase, and mitochondrial respiratory complex I in type II diabetic mice.

    Methods: Myocardial ischemia/reperfusion injury was produced in obese type 2 diabetic (db/db) and C57BL/6 control mice ex vivo in the presence or absence of isoflurane administered before ischemia. Read More

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